Individual
MS. LUCRETIA ANN BERG
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MSOT, OTR/L
Contact information
Practice address
12310 138TH AVE E, PUYALLUP, WA 98374-4539
(253) 973-1181
Mailing address
12310 138TH AVE E, PUYALLUP, WA 98374-4539
(253) 973-1181
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT00000852
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11216858
MULTIPLAN
WA
05
—
7682495
—
WA
01
—
7746376
AETNA
WA
01
—
BA8965
REGENCE BLUE SHIELD
WA
Enumeration date
04/26/2006
Last updated
07/09/2007
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